Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fayette Physician Network Inc

Organization Non-Pharmacy Dispensing Site · NPI 1245623453

Fayette Physician Network Inc is a Non-Pharmacy Dispensing Site in Grindstone, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2015.

Licensed in
PA
In the registry since
2015
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

111B Roberts Rd
Grindstone, PA 15442-1105
Phone: (724) 785-3187
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence OS016147 (PA)

Record details

NPI number1245623453
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Kenny Heine — Vp Of Operation · (858) 964-1506
Other names Fayette Physician Network- Brownsville
NPI enumeratedMarch 12, 2015
Last updated in NPPESMarch 12, 2015
Mailing address5626 Oberlin Dr, Suite 110, San Diego, CA 92121-1705